Provider Demographics
NPI:1033764204
Name:ROGALSKY, OMARA JUDITH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:OMARA
Middle Name:JUDITH
Last Name:ROGALSKY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 HAMBURG TPKE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-6226
Mailing Address - Country:US
Mailing Address - Phone:973-886-7685
Mailing Address - Fax:
Practice Address - Street 1:2440 HAMBURG TPKE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-6226
Practice Address - Country:US
Practice Address - Phone:973-839-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-05
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR13882700163WG0000X
NJ26NJ01019200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ363LF0000XOtherNURSE PRACTITIONER -FAMILY